Transcript United Nations Economic Commission for Europe Statistical Division Population Unit International initiatives on health and disability statistics Vitalija Gaučaitė Wittich 51st CSoD session, 12 February 2013

United Nations Economic Commission for Europe
Statistical Division
Population Unit
International initiatives on
health and disability statistics
Vitalija Gaučaitė Wittich
51st CSoD session, 12 February 2013
Current International Initiatives

Washington Group on Disability
Statistics (2001)

Budapest Initiative on the Measurement
of Health Status (2005)

Model Disability Survey initiative (2012)
Vitalija Gaucaite Wittich- UNECEPopulation Unit
Slide 2
Model Disability Survey
(WHO/WB initiative)


Prompted by the UN Convention on the Rights
of Persons with Disabilities (CRPD, art. 31)
Aims to produce a standardised survey
instrument to gather data that is:
•
Internationally comparable
• Allows to monitor national & global implementation
of CRPD

Needs to built on existing experience
(Washington Group, Budapest Initiative)
Vitalija Gaucaite Wittich- UNECEPopulation Unit
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Washington Group on
Disability Statistics
The main purpose is the promotion and co-ordination of
international co-operation in the area of health statistics
focusing on disability measures suitable for censuses
and national surveys

A question set about limitations in basic activity
functioning for use in national Censuses

Intends to compare levels of participation in employment,
education, or family life for those with disability versus
those without disability (social inclusion)
“City Group” – based on voluntary participation of statisticians across the
world working on health statistics
Vitalija Gaucaite Wittich- UNECEPopulation Unit
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Budapest Initiative on the
Measurement of Health Status


2004: Joint UNECE/WHO/Eurostat meeting on the
Measurement of Health Status
Broad consensus on


the need for multiple indicators to provide a full statistical picture
of population health, both for individual country use and for
international comparisons; and
the immediate need for an indicator of ‘health state’

Task Force created by CES Bureau in October 2004 with
the same Chairperson as Washington Group on Disability
statistics

The first meeting held in Budapest in November 2005;
since then known as the Budapest Initiative (BI)
Vitalija Gaucaite Wittich- UNECEPopulation Unit
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Budapest Initiative on the
Measurement of Health Status
Purpose: To develop a new common instrument to
measure health state suitable for inclusion in national
interview surveys to provide basic necessary information on
population health
Objectives:
 To develop a question set to assess overall health
state through a number of domains of functioning
 To describe trends in health over time within a country,
across subgroups of a population, and across countries
 To do so in the framework of official national
statistical systems
Vitalija Gaucaite Wittich- UNECEPopulation Unit
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Budapest Initiative on the
Measurement of Health Status
Guiding Principles for the Question Set:

Measure the health states of individuals

Operationalize health state as functional ability

Focus on capacity rather than performance
Measure across a parsimonious number of health
domains, capturing the most variation in health



Meet high standards of validity and international
comparability
Simple and clear, and easily translated into many
languages
Vitalija Gaucaite Wittich- UNECEPopulation Unit
Slide 7
Health Status and Health States
HEALTH STATUS
Health states
(capacities)
Determinants
of health
Genetic contribution
Lifestyle/behaviour
Domain 1
Physiological
Physiological
risk
factors
risk factors and
and risk
risk markers
markers
Diseases,
symptoms
and injuries
Domain 2
Death
.
.
Domain N1
Physical environment
.
.
Economic environment
Domain N2
Quality of life
Wellbeing
Social environment
Health State: an individual’s levels of functioning within a set of
health domains
Vitalija Gaucaite Wittich- UNECEPopulation Unit
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Budapest Initiative on the
Measurement of Health Status
Domains for BI Questions:
• Vision
• Hearing
• Walking / Mobility
• Cognition
• Affect
• Pain and fatigue
• Upper body (optional M1/incl.M2)
• Communication (optional M1/incl.M2)
Vitalija Gaucaite Wittich- UNECEPopulation Unit
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Budapest Initiative on the
Measurement of Health Status
First version of survey module (2005-2006)
• Tested in 2006 in 4 countries: Australia, Canada, Italy, U.S.
• Outcome: BI-M1 question set, endorsed by CES in 2007
Revised version of survey module (2008-2010)
• Developed in cooperation with Washington Group
• Three rounds of cognitive and field testing in 2008-2009
(in cooperation with WG and UNESCAP)
• Outcome: revised survey module finalized in 2010 and
endorsed by CES Bureau in 2011
Vitalija Gaucaite Wittich- UNECEPopulation Unit
Slide 10
Thank you
Available on UNECE website as
electronic publication:
“Survey Module
for Measuring Health State Developed by the
Budapest Initiative Task Force
on Measurement of Health Status”
http://www.unece.org/publication/survey_module_measuring_health_state.html
Vitalija Gaucaite Wittich- UNECEPopulation Unit
Slide 11